Provider Demographics
NPI:1811422496
Name:FARINELLA, JENNIFER PAIGE JOHNSON (MS, CFY-SLP)
Entity type:Individual
Prefix:
First Name:JENNIFER PAIGE
Middle Name:JOHNSON
Last Name:FARINELLA
Suffix:
Gender:F
Credentials:MS, CFY-SLP
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:PAIGE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CFY-SLP
Mailing Address - Street 1:3663 CROWN POINT CT
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257-5967
Mailing Address - Country:US
Mailing Address - Phone:904-288-8910
Mailing Address - Fax:904-288-8912
Practice Address - Street 1:3663 CROWN POINT CT
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-5967
Practice Address - Country:US
Practice Address - Phone:904-288-8910
Practice Address - Fax:904-288-8912
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-20
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist